Addressing skills gap key to transformation of Kenya’s health sector

People worldwide are living longer, an indication that many are reaping fruits of hard work to live their dreams and aspiration for a good life. Most people are entering into their sixties and living beyond. In fact, the world has entered into an ageing population where a bigger percentage of the population will be composed of older people.

A 2018 World Population Data Sheet from the Population Reference Bureau (PRB) projects the share of the population aged 65 or older will more than double to seven per cent from the current three per cent by 2050. Interestingly, this dramatic rise of the older population will happen in low and middle-income countries where Kenya lies.

What this development means is that we need to be well prepared to tackle a rise in a number of medical conditions including chronic conditions that come with old age. It presents a new challenge to the healthcare system that players in the sector must start to think about how to increase its capacity to deal with a large scale of chronic illnesses.

A bigger financial muscle will be needed to effectively care for the elderly population because it costs more to treat people who are ageing. This is in terms of facilities improvement, upgrade and innovation, adoption of home care which must be top on the priority list.

Healthcare systems in Kenya and Africa have for a long time been largely designed to care for the younger population, now accounting for the bulk of the population to find healthcare solutions to maternal health and infectious diseases. With the rapidly evolving patient needs and urgency to move with pace in leveraging and embracing technological advancement, our frontline workers must be able to quickly adapt and enhance their skills.

To care for the ageing population, we will require totally different policies, facilities, sufficient financial resources and most importantly skills for healthcare workers. We, therefore, need to address the existing skills gap to ensure we live up to and sustain the aspiration for a good life by promoting the well-being of this diverse population.

We are currently not doing so well in terms of available skills sets despite churning out high numbers of healthcare workers into the sector. In the health sector, the people getting employed are people with transferrable skills, because of a shortage in specialized skilled manpower.

The 2015 Kenya Health Workforce Report: The Status of Health Care Professionals in Kenya shows we are far away from meeting global staffing standards required to deliver quality health care. The report by the Kenya Medical Practitioners, Pharmacists and Dentists Union puts the doctor-to-patient ratio in the country at one to 17,000 against the World Health Organisation’s ratio of one to 1,000.

According to the report, Kenya has 2,204 active medical specialists of the 2,711 registered by the national doctors’ board. When we convert this to doctor population ratio you realise that we have an absolute deficit of 40,332 doctors required to meet WHO recommendations.

The shortage of doctors in Kenya and larger Sub-Saharan Africa has placed our healthcare system at a huge disadvantage. In fact, it is considered the root cause of Africa’s health challenges.

The shortage is a red alert that we urgently need to put more effort into the number of doctors we have to strengthen and transform our healthcare delivery system. A framework that is heavy on health financing is what we need to address the underlying factors contributing to a shortage of specialized frontline workers in the country. With proper financing mechanisms, we will be able to support the availability of essential medical products, adopt new technologies, and support human resource needs and timely delivery of services.

The framework should ensure most trainers live a meaningful standard of life by compensation to be able to churn out a competent workforce. Poor pay has for a long time been attributed to rising in healthcare workers flight to other industries or to self-employment or they go abroad

We also need to review the type of training that is available for healthcare workers and find ways of improving it with an aim of ensuring it is dynamic to changes and addresses current needs.

First, we need to bring on board more skilled specialists because the variety and availability of specialized training are currently being greatly hampered by a skills shortage. We achieve these by incorporating innovative methods of training which are less academic-oriented. It will ensure that institution do not just churn out many health professionals who just end up unemployed, but quality professionals who will fix existing gaps.

Secondly, a clear national roadmap based on identified skills gap on how best they can be bridged needs to be developed through consultation across levels of government together with the private sector and resources allocated efficiently.

Lastly, we must foster research as the basis to inform better decisions that meet the needs of Kenya’s population.

With a clear frontline workforce roadmap, the public sector can employ more doctors to accelerate universal healthcare coverage by strengthening key pillars of globally recognised standards of an effective health system.

The writer is a healthcare and management consultant.

gordon@gordonodundo.com